et-oriented. This market orientation has exhibited minimal regard for costs: "Evidence of inefficiency, duplication, and excessive overhead is everywhere apparent." The establishment of Medicare and Medicaid, through federal government intervention, has contributed to cost excesses. Despite these government programs, about 40 million Americans, an estimated 15 percent of the population, are without health insurance.
The elderly population is increasing steadily in the United States, and the growth of this segment of the population will bring a concomitant increase in the need for Long-Term Care (LTC). LTC consists of the need for nursing homes and other outpatient facilities. Unfortunately, the average elderly household cannot afford the insurance premiums for LTC coverage: "The General Accounting Office cites LTC insurance affordability at 20 percent for the 65 to 79 age group."
The demand for service at home health agencies (HHAs) far exceeds the supply. In a recent survey, numerous HHAs reported that their facilities are increasingly becoming inaccessible for elderly persons because of the complexity of health insurance eligibility criteria. For instance, persons with specific physical health or behavioral problems often found reimbursement by Medicare for treatment of their conditions difficult or impossible if hospitalization was not involved: "Like income, the nature of one's illness and one's service needs may also become liabilities when demand for services far exceeds available supply and providers have more opportunity to pick and choose among potential clientele."
Women's unique health issues have recently come to the forefront of national attention because of the emergence of the women's movement. Although women have better mortality rates than men, their morbidity rates tend to be worse. For most chronic diseases such as hypertension and arthritis, women have higher prevalence rates than men do. ...